Pre-cancerous cervical lesions could develop into cancer if they are not eliminated by your body's defense system or removed by a doctor. There are several ways to remove pre-cancerous cervical lesions, all of which must be performed by a doctor. The best type of treatment depends on the nature of the lesions.
Definition
Pre-cancerous cervical lesions are cells from your cervix with an abnormal shape, size or color that signals that they could develop into cancer cells. Often detected by a Pap smear, these lesions are almost always caused by persistent infection with a high-risk strain of human papillomavirus. HPV can cause genital warts, but in many cases it causes no symptoms at all. Annual Pap smears are important to detect pre-cancerous changes early, so they can be treated promptly.
Significance
If your Pap smear shows low-grade pre-cancerous cells, you might not need any treatment. Often those lesions will resolve on their own as your body's natural defenses kick in, and if not, they are years and years away from developing into cancer. Higher-grade lesions show more dramatic and abnormal cellular changes and require treatment because they are more likely to develop into cancer soon. Removal of the affected cells usually dramatically reduces the risk of cervical cancer.
Types
Treatment of pre-cancerous cervical lesions involves their removal. The lesions can be frozen off (cryotherapy or cold-knife conization), burned off (electrocautery), cut out with a scalpel or with a laser, or removed by photodynamic therapy. In photodynamic therapy, a light-activated chemical is applied to the cervix and stimulated with a special light to kill the pre-cancerous cells.
Benefits
If you have small lesions in an isolated area of your cervix, any of these treatments can effectively remove the lesions. Your doctor might recommend one form of treatment over another based on her experience with the treatment, the size and number of your lesions and whether fertility is an issue for you. Surgical and laser treatment, for example, require general anesthesia and can scar your cervix, which could prevent it from functioning normally in a subsequent pregnancy. Recent studies in "Anti-Cancer Research" and "Gynecologic Oncology" indicate that photodynamic therapy is less invasive and does not damage the cervix. This procedure can be done on an outpatient basis, and unlike some of the other treatments, photodynamic therapy can eliminate HPV infection as well.
Warning
Even after treatment, it is important to have a Pap smear at least once a year because pre-cancerous lesions can recur, especially if the HPV infection remains. You also can be re-infected with HPV from a sex partner, although using latex condoms can lower the risk.
References
- Mayo Clinic: HPV Infection
- Gynecologic Oncology; "Successful photodynamic therapy with topical 5-aminolevulinic acid for five cases of cervical intraepithelial neoplasia"; Jing Wang et al.; December, 2009
- Anticancer Research; "Cold-knife conization versus photodynamic therapy with topical 5-aminolevulinic acid (5-ALA) in cervical intraepithelial neoplasia (CIN) II with associated human papillomavirus infection: a comparison of preliminary results"; K. Bodner et al.; March-April 2003
